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Care After COVID-19

by -

Barb Wiley

Barb Wiley initially thought she ate something that didn’t sit well with her stomach when she experienced nausea and vomiting last July. The next day her upset stomach was followed by a headache and sore throat. Eventually the 67-year-old Shellsburg resident stopped drinking and eating.

“I just wasn’t hungry,” explained Wiley. “I was really tired, and after several days I wasn’t getting better, so I went to see my doctor. I tested positive for COVID-19. It was recommended I go to the hospital because I was dehydrated. I went to the ER and was admitted to St. Luke’s.

“Acute COVID-19 illness can leave even a previously healthy person very debilitated by the disease,” said Dianna Edwards, MD, St. Luke’s Hospitalist medical director. “The decline starts even before a patient enters the hospital. Commonly, COVID patients suffer from a lack of taste and smell, poor appetite and may experience symptoms such as nausea, vomiting or CARE AFTER COVID-19 diarrhea. Dehydration is common, and it is very difficult to maintain adequate hydration and nutritional intake needed to support their needs. During acute illness our bodies are working hard to fight and recover from disease. As disease severity increases, such as when pneumonia develops, COVID patients spend even more energy particularly to maintain their increased work of breathing.”

“I was just so tired,” shared Wiley. “I could hardly get out of bed to use the bathroom. I’ve never experienced that kind of fatigue. I was a little out of it but the nurses and staff at St. Luke’s were good about telling me what they were doing to care for me. At one point I remember one of the doctors telling me they might have to put me on dialysis if some of my numbers didn’t improve but thankfully, they started to get better, and I went home.”

Wiley's return home was short-lived. During a virtual follow-up doctor’s appointment, it was recommended she return to St. Luke’s because she was having trouble breathing.

“COVID-19 patients often experience profound fatigue and can become quite short of breath even with minimal exertion,” Dr. Edwards explained. “Activities such as getting out of bed to the chair for a meal or walking a few feet to the restroom can be quite challenging and requires increased respiratory effort. I counsel patients that nutrition, hydration and maintaining mobility are important aspects of their COVID recovery. Muscles follow the motto of ‘if you don't use it, you lose it’ and immobility leads to loss of muscle mass which can take weeks of therapy to recover.”

Transitional Care

Wiley had developed pneumonia and was at St. Luke’s a total of 12 days recovering from COVID-19. Afterward, she needed rehabilitation to help her regain strength and mobility, so she went to St. Luke’s Transitional Care Center. It’s a recuperative and supportive care center for patients to continue healing following an injury, surgery or serious illness. It’s designed for short-term rehabilitation, which includes daily, individualized therapy sessions to help patients regain their strength, stability and confidence to return home.

“Everything seemed to be finally going in the right direction,” said Wiley. “I was doing physical and occupational therapy at the center, and I was able to eat and drink again.”

After about eight days at St. Luke’s Transitional Care Center, Wiley went home.

“I was doing better but I wasn’t really confident yet,” explained Wiley. “I was able to walk short distances but not able to do stairs. You don’t realize how much energy everyday things take until you don’t have enough strength.”

Therapy for Strengthening and Conditioning

After a few weeks at home, Wiley reached back out to her UnityPoint Clinic provider, who recommended she go to St. Luke’s Physical Medicine and Rehabilitation outpatient therapy to help with additional strengthening and conditioning.

“When I first saw Barb, she was limited by shortness of breath and had low activity tolerance,” recalled Barb West, St. Luke’s Physical Medicine and Rehabilitation senior occupational therapist. “She needed a lot of rest breaks to complete tasks, and her heart rate would increase during activity. Each week we would work on new tasks, and she was able to gradually increase activities.”

“They did a great job helping me get my stamina back,” said Wiley. “If you were to tell me a couple of years ago that I would struggle just to fold laundry standing up, I wouldn’t have believed it. COVID just took such a toll on me.”

Wiley completed about five weeks of outpatient therapy at St. Luke’s twice a week and reports she is feeling about 90 percent back to normal.

“They really helped me a lot and thought of things for me to do to build my strength that I would never have thought to do on my own,” said Wiley. “They made a lot of difference for me and were really good. I am happy with where I am now.”

To learn more about St. Luke’s Physical Medicine and Rehabilitation, call (319) 369-7331 or email STL_PMR@unitypoint.org.

St. Luke's Transitional Care Center

St. Luke’s Transitional Care Center is designed to bridge the distance between a hospital setting and home. It's intended for short-term rehabilitation, which provides daily, individualized therapy sessions to help patients regain the strength, stability and confidence needed to function at their best.

St. Luke’s Transitional Care Center has nurse practitioners on-site five days a week, available to respond quickly to a patient's changing needs. The average length of stay is 14 days.

To learn more about St. Luke’s Transitional Care Center, call (319) 366-8701.